by Sarah Das
A sweep refers to detaching the fetal membranes away from the lining of the uterus.
There are prostaglandins (hormones) present in the lining of your uterus and in the fetal membranes and so by sweeping in this way the quantity of prostaglandin is increased and made available for good use – helping to initiate labour.
Why might I be offered a sweep?
Most women will go into labour spontaneously between 38 and 42 weeks of pregnancy. At 38 weeks your NHS midwife will discuss with you what happens if you do not go in to labour naturally and will usually outline the risks associated with pregnancies that go beyond 42 weeks.
Sometimes there are other medical reasons why it would be better for labour to start sooner rather than let nature take its natural course.
Either way you may be offered a sweep to encourage the body to start labour. It is the first step of induction of labour if you like and, if you are fortunate, the only type of encouragement that your body will need for labour to commence.
When is a sweep performed?
If it is your first baby, in order for birth to be completed by 42 weeks, some preparation and persuasion may be needed if there’s no sign of the baby coming when you get to the end of your 40th week of pregnancy.
So, at your 40 or 41 week check up you may be offered a sweep by your midwife or doctor.
If you’ve had a baby already you will be offered a sweep at 41 weeks of pregnancy.
You may need more than one sweep and the interval of time between sweeps will be decided by your midwife or doctor depending on your particular set of circumstances.
Do I have to have a sweep?
The goals of a sweep is to reduce the need to have a medical induction, which involves using synthetic forms of hormones. You will have a discussion about having a sweep with your carers and will make the decision together. If you decide not to go ahead and your pregnancy goes beyond 42 weeks you will typically be asked for more fetal checks, like the fetal monitoring of the baby.
How is a sweep performed?
A sweep can be performed in an antenatal clinic, in your GP surgery or in your home.
Your abdomen will be assessed first to make sure that the baby’s head is presenting first this means that baby is head down and that the head is in your pelvis. Details of your last scan will be checked to ensure that your placenta is anterior, which means that is well out of the way of your cervix.
Providing all is normal, a vaginal examination will then take place. In order for this to be done you will need to lie fairly flat on your back for a few minutes. This makes the examination much easier for your midwife or doctor to perform and despite lying flat, it is the most comfortable position for you.
The fetal membranes and lining of your uterus are accessed through your cervix and your cervix is situated beyond your vagina because it is positioned at the bottom part of your uterus. This may sound a long way up and hard to access but it’s not difficult for experienced midwives and doctors who regularly perform sweeps, for them it is quite an easy and routine examination.
But remember that they can’t SEE your cervix, they are relying purely on touch to perform the sweep, so the more relaxed and floppy your legs are during the examination the quicker and easier it is to get the job done. REALLY!
What happens after the sweep?
The baby’s heartbeat will be listened to on a hand-held baby monitor for a minute or so and provided this is normal (which it should be) you will go back to work or home and wait to see if labour starts in the next 24-36 hours.
You may experience some period-like pain in your lower back and abdomen that will gradually become contractions, contractions feel like a cramping pain that comes and goes in waves.
Most commonly you will see a brownish, pinky slightly red discharge from your vagina that will require you to wear a panty liner. This is quite normal. What you should not experience is heavy bright red bleeding or loss of blood clots.
You may experience none of the above and need another sweep for a labour-like response to kick-in.
Are there reasons why I would not be offered a sweep?
You should not be offered a sweep in you have a placenta praevia.
If the baby is not presenting head down.
If the babies’ head is not engaged with a first baby and at least partially engaged if you’ve already had at least one baby
There may be other reasons not to sweep that are particular to you and your pregnancy.
This will be explained to you at the time by your midwife of GP.
Is a Sweep Painful?
Having a sweep is not painful, but it can be uncomfortable as you will be unaccustomed to being examined and touched in such an intimate part of your body.